Analysis of the effect of clamping the anterior circulation aneurysm with the supralateral orbital approach and the pterional approach

doi:10.19854/j.cnki.1008-2425.2022.01.0006

Abstract

Abstract: Objective To investigate the effect of clamping the anterior circulation aneurysm with the supralateral orbital approach and the pterional approach.Methods 150 clinical data of patients with anterior circulation aneurysm admitted to our hospital from June 2015 to June 2020 were retrospectively selected as the research objects,and they were divided into the control group and the test group according to the different surgical methods,with 75 cases in each group.The control group was given the pterional approach to clamping the anterior circulation aneurysm,and the test group was given the supralateral orbital approach to clamping the anterior circulation aneurysm.Both groups were followed up for 6 months after surgery.The surgical indicators,the quality of life before and 6 months after surgery,and the occurrence of prognosis,recurrence during followed up were compared between the two groups.Results The length of surgical incision,the times of surgery and hospital stay in the test group were shorter than those in the control group,and the amount of intraoperative blood loss was lower than that in the control group(P＜0.05).Compared with before surgery,6 months after surgery,the scores of the physical,psychological,social relations and environmental fields of the two groups increased,the test group was higher than the control group(P＜0.05).During followed up,the proportion of patients with grade I~V assessed by glasgow outcome score(GOS) and the rate of recurrence in the test group(0.00%,0.00%,20.00%,20.00%,72.00% and 2.67%) compared with the control group(0.00%,0.00%,10.67%,29.33%,60.00% and 4.00%)) were not statistically difference(P＞0.05).Conclusion Supralateral orbital approach and the pterional approach clamping the anterior circulation aneurysm could both improve the prognosis and reduce the risk of recurrence of patients.However,compared with the pterional approach,the supralateral orbital approach to clipping the anterior circulation aneurysm had the advantage of small surgical incision,less intraoperative blood loss,short operation time,hospital stay and high the quality of life.In clinical practice,the surgical method suitable for the patient could be selected according to the specific situation of the patient with anterior circulation aneurysm in order to maximize the benefits of the patient.

Key words: Aneurysm, Anterior circulation, Supralateral orbital approach, Pterional approach, Clipping

摘要： 目的探讨眶上外侧入路与翼点入路夹闭前循环动脉瘤的效果。方法回顾性选取150例2015年6月~2020年6月我院收治的前循环动脉瘤患者的临床资料作为研究对象,根据手术方法的不同将其分为对照组和试验组,各75例。对照组给予翼点入路夹闭前循环动脉瘤,试验组给予眶上外侧入路夹闭前循环动脉瘤,两组均于术后随访6个月。比较两组手术指标,术前、术后6个月的生存质量及随访期间的预后情况、复发情况。结果试验组手术切口长度、手术时间及住院时间均短于对照组,术中出血量低于对照组(P＜0.05)。与术前比较,术后6个月,两组生理、心理、社会关系及环境领域评分均升高,试验组高于对照组(P＜0.05)。随访期间,试验组格拉斯哥预后评分(GOS)评估I~V级的患者占比情况及复发率(0.00%、0.00%、20.00%、20.00%、72.00%及2.67%)与对照组(0.00%、0.00%、10.67%、29.33%、60.00%及4.00%)比较,差异均无统计学意义(P＞0.05)。结论眶上外侧入路与翼点入路夹闭前循环动脉瘤均可在一定程度上改善患者预后,减少复发的风险,但相比翼点入路,眶上外侧入路夹闭前循环动脉瘤具有手术切口小、术中出血量少、手术、住院时间短、生存质量高的优势。临床临床可根据前循环动脉瘤患者具体情况选择适宜于患者的手术方式,以实现患者利益最大化。

关键词: 动脉瘤, 前循环, 眶上外侧入路, 翼点入路, 夹闭

CLC Number:

R732.2⁺1

Chen Min, Zhou Heping, Da Longbiao, et al.. Analysis of the effect of clamping the anterior circulation aneurysm with the supralateral orbital approach and the pterional approach[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2022, 35(1): 29-33.

陈敏, 周和平, 刘杰, 汪恒, 查正江. 眶上外侧入路与翼点入路夹闭前循环动脉瘤的效果分析[J]. 立体定向和功能性神经外科杂志, 2022, 35(1): 29-33.

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